No abstract available.

PURPOSE: CT and MR findings of cerebral fat embolism syndrome(CFES) have been rarely reported, because its diagnosis had been made on the basis of only clinical features in the majority of the cases. The purpose of this study is to describe the clinical, CT, and MR findings in six patients of CFES. MATERIALS AND METHODS: Brain CT and MR findings were retrospectively analyzed in six patients with CFES that was diagnosed on the basis of clinical and MRI findings. All six patients had long bone fractures and showed typical delayed clinical manifestations 2-3 days later. Both CT and MRI were examined in all of six patients. Initial CT scan was performed within 48 hours after trauma in all patients, andfollow-up CT scan was done in 2-11 days in two patients. MRI was done within 2-7 days after trauma in three patients, and 13 days, 18 days, and 45 days in other three patients. Follow-up MRI studies were performed in 2-60 weeks in four patients. Clinical and laboratory findings were analyzed retrospectively with medical records. CT and MRI findings were evaluated with regard to presence or absence of diffuse brain swelling and focal abnormalities of signal intensity(density). RESULTS: CT scans obtained within 2 days after trauma showed diffuse cerebral swelling in five patients and normal findng in one patient. On Tl-weighted MRI, diffuse cerebral swelling was shown in three cases and high signal spots suggesting cerebral petechial hemorrhage were noted in both caudate nuclei and thalami in two cases. On T2-weighted images, high signal spots which were shown on Tl-weighted image were not visible. In all of six cases, multiple lesions of high signal were observed mainly in the cerebral white matters, cerebellum and brain stem, probably representing ischemia/infarct or edema. On the follow-up MRI studies performed within a period from weeks to one month after trauma, the size and the number of the lesions were significantly decreased and these findings were well corresponded with clinical course. CONCLUSION: MR findings' of CFES include diffuse cerebral swelling, petechial hemorrhage and mi- croinfarcts, which characteristically improved in short period. In cases suspected of having CFES, MRI is more useful than CT for initial and follow-up studies because of its high detection rate of lesions and correspondence with clinical course.
Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Diagnosis ; Edema ; Embolism, Fat* ; Follow-Up Studies ; Fractures, Bone ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.
Autoantibodies ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia* ; Dermatomyositis* ; Dyspnea ; Fibrosis ; Humans ; Immunoglobulins* ; Immunosuppressive Agents ; Inflammation ; Lung Diseases, Interstitial ; Middle Aged ; Pneumonia ; Prognosis ; Respiratory Insufficiency ; Steroids

Purpose: This study examined the effects of social distancing in COVID-19 on musculoskeletal problems and the quality of life. Methods: One hundred and thirty-five subjects participated in this study and responded to an online survey on stress from the social distancing in COVID-19, computer and smartphone usages, musculoskeletal pain, and quality of life. The stress from social distancing was assessed by a Visual Analogue Scale (VAS). The Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Boston Carpal Tunnel Questionnaire (BCTQ) were provided to assess the musculoskeletal pain, and Short Form-36 (SF-36) was provided to assess the quality of life. Frequency analysis, descriptive statistics, Pearson’s correlation coefficient, and independent t-test were used for data analysis. Results: Statistically significant, but low positive correlation stress from the social distancing (VAS) and NDI (r=0.19, p<0.05) and ODI (r=0.18, p<0.05), and negative correlation between stress from the social distancing (VAS) and SF-36 (r=-0.17, p<0.05). The NDI score was significantly greater in the group with high stress than in the group with low stress from social distancing (p<0.05). Conclusion This study is meaningful in that it evaluated, through the physical therapy approaches, the potential side-effects on physical and mental health in various social changes caused by COVID-19. The results of this study may be used as basic data in future studies related to COVID-19.

Purpose: This study examined the effects of social distancing in COVID-19 on musculoskeletal problems and the quality of life. Methods: One hundred and thirty-five subjects participated in this study and responded to an online survey on stress from the social distancing in COVID-19, computer and smartphone usages, musculoskeletal pain, and quality of life. The stress from social distancing was assessed by a Visual Analogue Scale (VAS). The Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Boston Carpal Tunnel Questionnaire (BCTQ) were provided to assess the musculoskeletal pain, and Short Form-36 (SF-36) was provided to assess the quality of life. Frequency analysis, descriptive statistics, Pearson’s correlation coefficient, and independent t-test were used for data analysis. Results: Statistically significant, but low positive correlation stress from the social distancing (VAS) and NDI (r=0.19, p<0.05) and ODI (r=0.18, p<0.05), and negative correlation between stress from the social distancing (VAS) and SF-36 (r=-0.17, p<0.05). The NDI score was significantly greater in the group with high stress than in the group with low stress from social distancing (p<0.05). Conclusion This study is meaningful in that it evaluated, through the physical therapy approaches, the potential side-effects on physical and mental health in various social changes caused by COVID-19. The results of this study may be used as basic data in future studies related to COVID-19.

This study aimed to evaluate the efficacy of random-start controlled ovarian stimulation (COS) in cancer patients for emergency fertility preservation. In this retrospective comparative study, 22 patients diagnosed with cancer and 44 infertile women undergoing conventional in vitro fertilization (IVF) were included. In cancer patients, ovarian stimulation was started on the day of referral, irrespective of their menstrual cycle date. The control group was selected by age matching among women undergoing conventional IVF. COS outcomes were compared between groups. The number of total and mature oocytes retrieved and the oocyte maturity rate were higher in the random-start group than in the conventional-start group. However, duration of ovarian stimulation was longer in the random-start group (11.4 vs. 10.3 days, P = 0.004). The addition of letrozole to lower the estradiol level during COS did not adversely affect total oocytes retrieved. However, oocyte maturity rate was lower in cycles with letrozole than in cycles without letrozole (71.6% vs. 58.2%, P = 0.019). Our study confirms the feasibility and effectiveness of random-start COS in cancer patients.
Cryopreservation ; Estradiol/blood ; Female ; Fertility Preservation/*methods ; Fertilization in Vitro ; Humans ; Infertility, Female/surgery ; Neoplasms ; Nitriles/therapeutic use ; Oocyte Retrieval/*methods ; Ovulation Induction/*methods ; Retrospective Studies ; Triazoles/therapeutic use

This study aimed to evaluate the efficacy of random-start controlled ovarian stimulation (COS) in cancer patients for emergency fertility preservation. In this retrospective comparative study, 22 patients diagnosed with cancer and 44 infertile women undergoing conventional in vitro fertilization (IVF) were included. In cancer patients, ovarian stimulation was started on the day of referral, irrespective of their menstrual cycle date. The control group was selected by age matching among women undergoing conventional IVF. COS outcomes were compared between groups. The number of total and mature oocytes retrieved and the oocyte maturity rate were higher in the random-start group than in the conventional-start group. However, duration of ovarian stimulation was longer in the random-start group (11.4 vs. 10.3 days, P = 0.004). The addition of letrozole to lower the estradiol level during COS did not adversely affect total oocytes retrieved. However, oocyte maturity rate was lower in cycles with letrozole than in cycles without letrozole (71.6% vs. 58.2%, P = 0.019). Our study confirms the feasibility and effectiveness of random-start COS in cancer patients.
Cryopreservation ; Estradiol/blood ; Female ; Fertility Preservation/*methods ; Fertilization in Vitro ; Humans ; Infertility, Female/surgery ; Neoplasms ; Nitriles/therapeutic use ; Oocyte Retrieval/*methods ; Ovulation Induction/*methods ; Retrospective Studies ; Triazoles/therapeutic use

Purpose: The gene expression test (GET) was used to predict the response to chemotherapy and the recurrence risk.Several randomized clinical trials have demonstrated that some patients with node-positive disease can achieve favorable survival outcomes even without adjuvant chemotherapy. This study aimed to predict the results of Oncotype DX (Genomic Health) and MammaPrint (Agendia) using traditional clinicopathological factors. Methods: We reviewed the records of 311 patients who underwent GET for hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative primary invasive breast cancer with node-positive disease between 2015 and 2022 at Severance Hospital and Gangneung Asan Medical Center. Univariate and multivariate logistic regression analyses assessed the relationships between clinicopathological variables and risk stratification using the GET results. Results: A simple scoring system was created by assigning integer values to each variable. A score of 3 was assigned for histological grade 3, a score of 2 for pathologic T2 or above, and a score of 1 for a lower progesterone receptor (1–20 or Alled score 3–6), HER2 2-positive, and high Ki-67 (>20). In the validation cohort, overall accuracy was 0.798 (95% confidence interval, 0.744–0.844). Conclusion The high GET risk results can be predicted using traditional clinicopathological factors: tumor size, progesterone receptor, histological grade, HER2, and Ki-67. These results will be useful for treatment decision-making among clinically high-risk patients with HR-positive/HER2-negative and node-positive disease, helping to identify patients to whom the GET assay may not apply.

Osteoarticular tuberculosis is often misdiagnosed as other disease because of a rare incidence and nonspecific clinical and radiographic presentation. Therefore, it is important to know clinical and radiographic presentations of osteoarticular tuberculosis and to diagnose in early phase. Especially, fistula formation is one of the most important clinical features which suspects osteoarticular tuberculosis. We report a case of ankle tuberculosis to be misdiagnosed as subtalar osteoarthritis and performed subtalar arthrodesis.
Animals ; Ankle ; Arthritis ; Arthrodesis ; Fistula ; Incidence ; Osteoarthritis ; Subtalar Joint ; Tuberculosis ; Tuberculosis, Osteoarticular